Being triaged for a GP phone appoitment by GPs Receptionist

[Pennox]

Curious to know if others think IABU here as this is a particular bug bear of mine. I should say that in the past I have had 2 particular concerns about GP receptionists which maybe colour my view. One, my mother was briefly a GP receptionist (not recently) and used to tell us all sorts about the patients at the surgery, much of which was personally identifiable if you knew those people in the local community. Secondly, I was given incorrect medical information by my own GPs receptionist just prior to Covid regarding my son which she shouldn't have been giving me anyway, and was given in an attempt to get me to go away and not persist in asking for an appointment, but, more importantly, because it concerned a severe allergy, could have been very dangerous if I'd not known it was rubbish and followed it. (And no I did not officially complain at the time as the practice makes that really difficult and covid kicked off, I should have done.) Anyway.

I had covid approx. 5 weeks ago and was feeling pretty much over it after 2 weeks of pretty rubbish flu type effects and then 2 weeks of fatigue, joint aches etc. So by end of last week was thinking great, I'm back! after a surprisingly rough month. I did not seek any medical attention during this time and self-managed. However, I think I've now developed a secondary chest and sinus infection which is getting worse and worse, all the usual gross symptoms which I wont detail here and got to the stage where I am feeling really rough again and cant work properly (from home). Im really behind at work after the initial 4 days off that I took and then being ill/fatigue/brian fog for another 3 weeks. So I reckon I may need antibiotics now and it wont just go away on its own - I'm not a medic but when this has happened a couple of times in the past that is what has inevitably happened. So, basically, I need a GP appt. To check and hopefully get some antibiotics. Online booking is 3 weeks out. So only option is the GP prescribed practice of phoning at 8 to ask for a same day/emergency appointment. Thisbused to involve queuing round the block at 8 as was impossible to get through on the phone. They've somewhat addressed this now so after about a 30 minute wait I got through and asked for a same day appointment and surely is a yes or no response, yes we have one available, no we do not. But they of course then ask you why. So I said I had covid recently and now think I may have developed a chest infection at the end of it and might need antibiotics to clear it up. She then started asking me a long list of medical questions about my symptoms. Was I coughing? Did I have a temperature? Was I coughing up phlegm? Was there blood in the phlegm? At this point I said can I ask you why you are asking me these questions? Is this my appointment? She said I am triaging you before putting you through to the list for a GP phone appointment (they are still doing all initial appointments over the phone). I asked if she was a nurse then or medically trained and she said no I am a receptionist but the GPs give us this list of questions to ask before we decide whether to put you through for an appointment or not.

AIBU to think that they shouldnt have non-medically trained people triaging attempts to get a GP appointment?

Its not so bad in this instance - the receptionist and the rest of the surgery now know I've got symptoms of a possible chest infection (its open plan and they're in the main reception), so what?. But bearing in mind she'd just confirmed my name, asked for my date of birth and echoed it back at me over the phone in front of who knows who standing in line in the surgery in front of her (that I can't see and could be my neighbour for example). What if it had been a call about depression or mental health/suicide or domestic violence? And more fundamentally than that, is it really appropriate to have non-medically trained reception staff, not bound by the same professional conduct standards as doctors and nurses, deciding who actually needs medical attention in the form of a doctors appt, and how quickly, or not?

I am sorry about your mum - however I do question your mother's carer giving that advice (and that the 999 operator didn't correct them)

I know last year when my father passed away at home, when the DNAR was agreed and he was pallitive care at home we were told when he died not to ring an ambulance, when I rang the GP and asked for the doctor to come over to certify his death (admittedly the receptionist did ask if I'd called an ambulance - so the carer isn't only one to think that they should call an ambulance, I pointed out that an ambulance wouldn't help, that I just wanted the GP to come and certify the death) GP rang back within minutes and said it would either be her or the doctor who had seen him the day before, that they would be there within 15 minutes and they were.

I know my mum had called the nurse overnight after he had died to ask what to do (they did come and help lay him out in the early hours)

“But what has changed? Pre-pandemic, you rang up and made an appointment, no one triaged it. Neither DH or I have seen a GP since before the pandemic. Why can't you just ring and get an appointment like you used to?”

Because demand has gone through the roof and clinician numbers are falling though the floor. More people than ever before want appointments and less clinicians are available to see them.

What has made demand go up I’m not sure. It isn’t just a short term post covid bounce either - it was going this way pre covid and now it’s worse. Some of it is everywhere demanding a GP appointments for everything - need a foodbank - see your Gp, want to join a gym - get a letter from your Gp etc….some is from other services being cut - HV service cuts mean babies have to be weighed by GPs, community clinics for diabetics etc cut so now managed by GP, some is the elderly population……I could go on.

It’s generally a horrid place to work and now the government is talking about compulsory purchases of businesses etc, no one is going to want to buy in to partnership as a GP or invest in the infrastructure if the government os going to compulsory purchase it in the next couple of years, ditto people don’t want to be employed in places if they think their gonna loose their jobs.

www.bma.org.uk/advice-and-support/nhs-delivery-and-workforce/pressures/pressures-in-general-practice-data-analysis

@LuluBlakey1 The reason is a surge in demand.

Backlogs in routine care both in GP and hospital settings means problems that could wait a few months ago now can’t, hence more and more people ringing for the same number of appointments. I’m a GP. Our receptionists are told to triage. We literally have no time to do it ourselves and have to find a way to prioritise objectively urgent care. Our main receptionist is a trained paramedic and our other receptionist has many years of triage experience in the practice. They are trained professionals and a crucial part of our team. They are not seeking medical information as a power trip or source of gossip- not that you’re suggesting that, it just really frustrates me when people dismiss the role they play.

As a former GP receptionist, I can assure you they don't care what ailments you have. They don't want to have to ask you such personal questions, but they have to.

And they're also taught to navigate care to the most appropriate facility, such as the pharmacy.

@LuluBlakey1 my GP surgery triaged you pre-pandemic. In fact all the GPs practices I've belonged to since about 2003 have triaged patients.

The difference in my practice is now they are trying to get you to ask for the right HCP and appointment type when you contact them, and they are trying to make you contact them by online means only.

This is fine when their system works and they have connected up the right apps, but not when they aren't. (You just made me realise they have made a mistake about an appointment.)

@YoureAMeanOneMrGrinch I don't care what ailments people have, one female patient didn't want to say she had a breast lump but a male patient happily unprompted told me he had a testicular lump and when he lifted his scrotum it was there. I recorded the details for the GP and answered the next call.

@WhatWhatWhatAgain

At my surgery, you access Econsult through the surgery website. It asks fairly detailed questions including some about family history, and they are committed to a doctor ringing you within two working days. Last time I tried, about a year ago, it was that or a two-week wait for a phone appointment. Anything in a receptionist’s script could be done on line so it’s not unreasonable to expect that option to be available.

Not necessarily.

I spent 35 minutes faffing around with my GP's app where there was no facility to say 'I've got a massive flare of Psoriasis'. I had to go through and answer the lengthy questions as though I'd never had it before. Of course the GP looked at it, looked at my records and realised 'oh yeah, she's got Psoriasis' - but had I been able to speak to a human being, they would have understood and been able to put me on the list as having a massive flare of Psoriasis. If I were to have an injury/joint swelling, I can't just say 'I'm having a massive flare of Psoriatic Arthritis and my foot has swollen up like a balloon', I have to pretend that I've injured it, but not enough that it triggers a 'go to A&E' message. And if I've come into contact with somebody with chickenpox/scarlet fever/etc, there is no option to say 'I'm on biologic medication for Psoriatic Arthritis and I've been in contact with somebody with chickenpox/scarlet fever and my consultant said if that happened I needed an urgent appointment for antivirals/possibly antibiotics'.

But give me a human being - one who can ask extra questions, can understand the situations that don't fit into the convenient flows programmed by people who don't have to think of boring things like already disabled people or those with chronic conditions with exacerbations or that complicate normal situations - and everything is easy.

It's the ability to go off script (as patients go off script what with being human and not little robots) that makes the trained receptionist a far better option for many people. And I'd rather somebody was in a job than a US IT firm gets another few million quid out of the NHS.

It’s just a list of questions. If you answered yes to coughing up blood it would be a&e.

Rather than moan about the the receptionist, you would be better off speaking g to the practice manger as it would have likely been devised by the Gp’s and practice manger or CCG

@NeverDropYourMooncup
All good reasons for talking to a well-trained receptionist. However, I don’t think a well-trained computer is an unreasonable demand either.

Ours has apps etc designed to ensure it is hard to make contact eg they were not taking calls the other week and the website was "down2 for a few days and you could not walk in to make an appointment at the counter as you always used to be able to do. Luckily I have only needed a doctor for 7 minutes in 15 years (luckiest woman my age in the UK in my view although the luck will not last forever). My son was sent to A&E when he eventually got to see our GP recently which we felt was a bit of a waste of resources the system - there should be a better way to get his minor op without being sent to A&E.

Yabu. When my grandmother was having a stroke my grand father phoned the GP surgery to ask for an appointment. If the receptionist had carried out his request and booked her in, she would have died on the kitchen floor. Fortunately as the receptionist asked a few pertinent questions, 999 was called and my grandmother received the treatment needed

I chose the GP surgery based on the receptionists. They are professional and do a decent job with a huge volume of calls. They can sign post me to various services if I need (to avoid GP if I cant find out on line). I dont find them 'gossipy'. They ask the same questions- and are discrete.

On the other side, I find the GPs at the surgery generally woeful- but thankfully I dont need them that often.

@Pigsears
What process did you use? Did you phone up and interview them or move from practice to practice?

Where I live there are a choice of places to register. So i rang the various places until I found one that sounded ok.

Can generally tell if people are super stressed and unhelpful over the phone. Its not failsafe- but worked out ok.

Kind / professional people tend to employ the same type- so no reason to move surgery once registered. I dont use them super often.

so not an 'interview' per se.

This isn't really the same thing, but I don't want to start another thread.

I've had 2 text messages from my surgery advising me to arrange a Health Check. I presume this is a regular over 50s check.

I'd like to call so I can make an appointment that suits me, but when I call the message states their lines are very busy and only to call if it's really important, and then lots of pointers to e-consult etc.

So, I just feel like they'll be pissed off that I'm calling for something non-urgent, even though I've been invited.

Even mid-afternoon? Does it tell you to call on the letter or is there my alternative way to arrange the appointment?

@ResurrectionInfinity

Even mid-afternoon? Does it tell you to call on the letter or is there my alternative way to arrange the appointment?

Yes, it's the same message whenever you call. The text gives their phone number and an general email address. I'm sure if I email them they'll ask me to call to make an appointment.

I'll call them - I just feel like they don't want me to, even though they've asked me to!

Yes, call them.

I did and it's all fine. I think they just need to update their recording.
If they are now able to do routine health checks then they're obviously doing OK staff and workload wise.

The majority of doctors receptionists are much to be desired.